EVALUATION OF SERUM VITAMIN B12, FOLATE, AND HEMATOLOGICAL PARAMETERS IN WOMEN WITH RECURRENT PREGNANCY LOSS
Main Article Content
Keywords
Recurrent pregnancy loss, Vitamin B12, Folate, Anemia, Hematological parameters, Miscarriage
Abstract
Background: Recurrent pregnancy loss is a painful reproductive disorder, which impacts maternal physical and psychological health. Nutritional and biochemical factors like low levels of vitamin B12 and folic acid, and other related hematologic dysfunctions can be one of the causes of recurrent miscarriage by disrupting DNA production, erythropoiesis, and placental development.
Objective: To evaluate serum vitamin B12, folate, and hematological parameters in women with recurrent pregnancy loss.
Methods: The cross-sectional study was an analytical study that was designed and conducted at Pak International Medical College, Peshawar between January 2023 and June 2023. There were 72 women having recurrent pregnancy loss. Structured proforma was used to record demographic and obstetric information. Blood samples were taken to be estimated of serum vitamin B12, serum folate and hematological parameters such as hemoglobin, red blood cell count, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, red cell distribution width, white blood cell count and platelet count. The data analysis was done using SPSS version 26 and a p-value was taken as 0.05.
Results: The mean age of participants was 29.8 ± 5.1 years. Vitamin B12 deficiency was found in 37.5% of women, while folate deficiency was observed in 26.4%; 19.4% had combined deficiency. Anemia was present in 63.9% of participants, with mild anemia being most common. Women with a higher number of pregnancy losses had significantly lower mean vitamin B12, folate, and hemoglobin levels (p<0.05). First-trimester loss was the most frequent presentation.
Conclusion: Vitamin B12 deficiency, folate deficiency, and hematological abnormalities were common among women with recurrent pregnancy loss. Lower micronutrient levels were significantly associated with increasing number of pregnancy losses. Screening for these deficiencies may help in the evaluation and management of recurrent pregnancy loss.
References
2. Zec, M., et al., Vitamin B12 supplementation in addition to folic acid and iron improves hematological and biochemical markers in pregnancy: a randomized controlled trial. 2020. 23(10): p. 1054-1059.
3. Bala, R., et al., Hyperhomocysteinemia and low vitamin B12 are associated with the risk of early pregnancy loss: a clinical study and meta-analyses. 2021. 91: p. 57-66.
4. Ransome, N.J., The laboratory assessment of haemoglobin, Ret-He, IRF, plasma ferritin, serum vitamin B12 and folate deficiency in anaemic and non-anaemic women during pregnancy: can laboratory screening predict outcomes? 2022, Manchester Metropolitan University.
5. Mahdi, S.A.-H. and H.A.-A.J.I.j.o.h.s. Mohammed, Effect of zinc, ferritin, and vitamin B12 deficiency on hair loss in pregnant women. 2022. 6(S4): p. 9737-9747.
6. Saleem, H.M., et al., Physiological, hematological and some biochemical alterations during pregnancy. 2022. 6(S6): p. 7156-7169.
7. Patel, P. and N.J.C. Balanchivadze, Hematologic findings in pregnancy: a guide for the internist. 2021. 13(5).
8. Shibbl, F.A. and Y.H.J.A.o.t.R.S.f.C.B. Sharif, The Role of Hyperhomocystinemia in Recurrent Pregnancy Loss. 2021. 25(6): p. 10129-10137.
9. Farah, H.S., et al., The association between the levels of Ferritin, TSH, Zinc, Hb, vitamin B12, vitamin D and the hair loss among different age groups of women: A retrospective study. 2021. 13: p. 143-8.
10. Naim, Z., M.A. Auda, and N.J.A.o.t.R.S.f.C.B. Saddam, The effect of homocysteine, some vitamins in women who suffer from recurrent miscarriage in Thi-Qar province/Iraq. 2021. 25(1): p. 4840-4851.
11. Wu, Y.-H., et al., Significantly higher frequencies of macrocytosis, anemia, serum vitamin B12 and folic acid deficiencies, and hyperhomocysteinemia in male than in female atrophic glossitis patients. 2022. 17(3): p. 1371-1377.
12. Sultana, M.N., et al., Comparison of Blood Homocysteine Levels between Women with Recurrent Pregnancy Loss and Women with Normal Fertility. 2021. 11(1): p. 10-17.
13. Yuan, X., et al., Association of folate and vitamin B12 imbalance with adverse pregnancy outcomes among 11,549 pregnant women: An observational cohort study. 2022. 9: p. 947118.
14. Paffoni, A., et al., Folate Levels and Pregnancy Rate in Women Undergoing Assisted Reproductive Techniques: a Systematic Review and Meta-analysis. Reproductive Sciences, 2022. 29(2): p. 341-356 DOI: 10.1007/s43032-021-00467-9.
15. Dib, M.-J., et al., Evaluating the Diagnostic Value of a Combined Indicator of Vitamin B12 Status (cB12) Throughout Pregnancy. 2022. Volume 8 - 2021 DOI: 10.3389/fnut.2021.789357.
16. Wu, Y.-H., et al., Significantly lower mean serum vitamin B12 and folic acid levels and a significantly higher frequency of serum iron deficiency in younger than in older atrophic glossitis patients. Journal of Dental Sciences, 2022. 17(4): p. 1487-1493 DOI: https://doi.org/10.1016/j.jds.2022.05.023.
17. Behere, R.V., et al., Maternal Vitamin B12 Status During Pregnancy and Its Association With Outcomes of Pregnancy and Health of the Offspring: A Systematic Review and Implications for Policy in India. 2021. Volume 12 - 2021 DOI: 10.3389/fendo.2021.619176.
18. Cirillo, M., et al. 5-Methyltetrahydrofolate and Vitamin B12 Supplementation Is Associated with Clinical Pregnancy and Live Birth in Women Undergoing Assisted Reproductive Technology. International Journal of Environmental Research and Public Health, 2021. 18, 12280 DOI: 10.3390/ijerph182312280.
19. Ota, K., et al., Effects of MTHFR C677T polymorphism on vitamin D, homocysteine and natural killer cell cytotoxicity in women with recurrent pregnancy losses. Human Reproduction, 2020. 35(6): p. 1276-1287 DOI: 10.1093/humrep/deaa095.
20. Haile, K. and A. Timerga, Evaluation of Hematological Parameters of Helicobacter pylori-Infected Adult Patients at Southern Ethiopia: A Comparative Cross-Sectional Study. Journal of Blood Medicine, 2021. 12(null): p. 77-84 DOI: 10.2147/JBM.S294958.
21. Sobczyńska-Malefora, A., et al., Vitamin B12 status in health and disease: a critical review. Diagnosis of deficiency and insufficiency – clinical and laboratory pitfalls. Critical Reviews in Clinical Laboratory Sciences, 2021. 58(6): p. 399-429 DOI: 10.1080/10408363.2021.1885339.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Anjum Mahmood
Associate Professor, Department of Obstetrics and Gynaecology, Pak International Medical College, Peshawar, Pakistan
Malaika Zia
Women Medical Officer, Department of Obstetrics and Gynaecology, Women and Children Teaching Hospital, Bannu, Pakistan
Shaita Shaikh
Demonstrator, Department of Biochemistry, Chandka Medical College Shaheed Mohtarma Benazir Bhutto Univerisity, Larkana, Pakistan
Madeeha Jadoon
Associate Professor, Department of Biochemistry, Women Medical and Dental College, Abbottabad, Pakistan
Farah Liaquat
Assistant Professor, Department of Obstetrics and Gynaecology, Baqai Medical University, Karachi, Pakistan
Sidra Humayun
Asssociate Professor, Department of Pathology, Muhammad College of Medicine (MCM), Peshawar, Pakistan
